U. Merz et al., Partial liquid ventilation with surfactant: effects on gas exchange and lung pathology in surfactant-depleted piglets, INTEN CAR M, 26(1), 2000, pp. 109-116
Objective: To evaluate the effects of 24 h partial liquid ventilation (PLV)
with and without surfactant (S) treatment on gas exchange and lung injury
in a newborn animal model of S deficiency.
Design : A prospective, controlled, in vivo animal laboratory study.
Setting: Research laboratory in a university setting.
Subjects: Twenty-four pathogen-free, male piglets (mean weight 1.9 kg, age
1-3 days).
Interventions: The animals were randomised in four groups: PLV with FC-77 c
ombined with conventional ventilation (PLV/CV) versus S + PLV/CV and PLV co
mbined with high frequency oscillatory ventilation (PLV/HFOV) versus S + PL
V/HFOV. The piglets were anaesthetised, intubated and instrumented with vas
cular catheters. Thirty minutes after lung injury had been induced with rep
eated saline lavage, S animals received natural S, Thirty minutes after sur
factant substitution PLV with FC-77 was started. The oxygenation index (OI)
, PaO2/FIO2 ratio, PaCO2 and the ventilatory efficacy index were determined
before and during PLV. After 24 h the lungs were removed for histopatholog
ical examination.
Measurements and main results: Within 60 min after the initiation of PLV, a
ll animals demonstrated improvements of the OI and PaO2/FIO2 ratio compared
to the values after lung injury. However, at 18 and 24 h of PLV, the OI an
d PaO2/FIO2 ratio were significantly worse in the S + PLV/CV and S + PLV/HF
OV groups compared to the groups without S. PaCO2 was higher at 18 and 24 h
when S was used in PLV/HFOV (p < 0.05). A semi-quantitative lung injury sc
ore revealed most severe lung damage in the S + PLV/HFOV group.
Conclusion: The combination of S and PLV with FC-77 led to an impaired gas
exchange and did not further protect the animal from lung injury.